Trust matters: A practice-level look at patient confidence in health professionals

Today, we’re speaking to Professor Richard Baker, emeritus Professor at the University of Leicester.

Title of paper: Factors influencing confidence and trust in health professionals: a cross-sectional study of English general practices.

Available at: https://doi.org/10.3399/BJGP.2025.0154

A transactional model of general practice is being introduced to improve access that involves triage and increasing percentages of appointments with professionals other than GPs or that are not face-to-face. Using summary data about almost all English general practices in 2023-24 with 750 or more patients, the patient-reported levels of confidence and trust from the General Practice Patient Survey were associated with increased percentages of appointments that were with GPs or were face-to-face, and with higher continuity, after adjusting for other practice and patient factors. Confidence and trust was lower in practices with fewer appointments per year per patient, fewer patients having their needs met, greater deprivation, fewer patients of White ethnicity, and in practices located in London, as compared to other regions of England. Access to general practice needs improving, but the findings of this cross-sectional study suggest that preserving features of relationship-based care is also needed to maintain patients’ trust and confidence in health professionals.

Transcript

This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.

Speaker A

00:00:01.200 - 00:00:46.980

Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for joining us here to listen to this podcast today.

In today's episode, we're speaking to Professor Richard Baker, Emeritus professor at the University of Leicester. We're here to talk about the paper that he and his colleagues have recently published here in the bjjp.

The paper is titled Factors Influencing Confidence and Trust in Healthcare A Cross Sectional Study of English General Practices. So, hi, Richard, thanks for joining me here today and it's nice to see you again.

Just before we talk about this paper, I wonder if you could just talk to me about trust and why you think it's important in general practice interactions.

Speaker B

00:00:47.780 - 00:01:32.060

Well, it's difficult to have a consultation with a patient if they don't trust you. I mean, it's just very basic, a very basic level, very simple level. But there's lots of evidence as well that trust is important.

People who trust you are more likely to follow your advice. They're more likely to take the medication.

They're more likely therefore, to come back and see you again, more likely to use services appropriately in the future. And there's some evidence that the outcomes are better if there's trust there. Trust obviously should be earned.

You can't take it for granted, you've got to be trustable. But it's obviously very important for clinical practice and essentially always has been, hasn't it, really? Going back to the.

The Greek doctors, trust was important then, just as it is now.

Speaker A

00:01:32.460 - 00:01:38.540

And you mentioned about different outcomes. So what sort of outcomes do we know could be associated with trust?

Speaker B

00:01:39.180 - 00:02:07.990

Just use of services is one example.

So you can get people who, if they don't trust who they see, they go and see someone else and again, and so they overuse services and that waste resources.

On the other hand, you may get people who just won't come, so they'll delay presenting with the problems because they don't trust the provider to get it right. Then they risk of poor outcomes as a consequence of that. So it's a whole mixture of things.

Speaker A

00:02:09.030 - 00:02:21.190

So what were you trying to do in the study?

So you wanted to look at trust and how it impacted on patient outcomes, or was it more about sort of the predictors and associations with trust, isn't it?

Speaker B

00:02:21.800 - 00:04:33.330

Yes, I think we were conscious that general practice has gone through a lot of change.

The big changes came about during the pandemic as to how general practice is delivered, how people have their appointments and things have sort of Reverted a bit to how they were, but only partially in terms of who you get to see face to face, appointment and so on. And we were asking the question, well, what has been the consequence of this?

Should we be thinking about confidence and trust in association with these changes?

I mean, the changes may have been absolutely essential because we just don't have the capacity in general practice to do everything that we would like to do for an increasingly multi morbid population. But what are the consequences? How do we need to respond? How do we need to respond?

Questions I guess for follow on from Is there a link between confidence and trust and these changes in general practice changes?

I think when we looked at this, we've sort of grouped them, we sort of imagined that there are two models of general practice which the relationships based care and the transactional model. Of course there aren't two models, it's all mixed up. But to simplify it, you call it two different things.

And we've tried to categorize or explain what relationship based care might be, which has typified by high context